Emily Lauren Ellis, CRNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

SP022466 Issued in PA

Practice address

25 Church St
Wilkes Barre, PA 18702-3507

Phone

(570) 808-3181

Fax

(570) 808-8996

NPI assigned

Sep 12, 2020

Last updated

Jun 28, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Emily Lauren Ketterman Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eketterman430749@direct.geisinger.edu

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Advanced Inpatient Medicine Transitional Care - Ltcaco LLC

  • Internal Medicine Physician
  • Wilkes Barre, PA
  • NPI 1427944859
  Medicare reassignment NPD
• Advanced Inpatient Medicine Transitional Care PC

  • Internal Medicine Physician
  • Wilkes Barre, PA
  • NPI 1609247030
  Medicare reassignment NPD
• Geisinger Clinic

  • Family Medicine Physician
  • Danville, PA
  • NPI 1366493868

  Nurse Practitioner

  Medicare reassignment NPD
• Geisinger Clinic

  • Diagnostic Radiology Physician
  • Danville, PA
  • NPI 1558313023
  NPD
• Geisinger Clinic

  • Hematology & Oncology Physician
  • Danville, PA
  • NPI 1932150331

  Nurse Practitioner

  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1599868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1780299123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 CHURCH ST",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187023507",
            "telephone_number": "570-808-3181",
            "fax_number": "570-808-8996"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "680 Blair Mill Road",
            "address_purpose": "LOCATION",
            "city": "Horsham",
            "state": "PA",
            "postal_code": "19044",
            "country_code": "US",
            "telephone_number": "570-406-5772",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "EMILY",
        "middle_name": "LAUREN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-12",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP022466",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP022466",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eketterman430749@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "25 Church St",
            "city": "Wilkes Barre",
            "state": "PA",
            "country_code": "US",
            "postal_code": "187023507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "KETTERMAN",
            "middle_name": "LAUREN",
            "credential": "CRNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lois Elick, RN
• Matias Elijovich, M.D.
• Elite Spine and Sports Physical Therapy
• Elite Spine and Sports Physical Therapy LP
• Anna Elkin-Wren, LCSW
• Heba Gamal Elrawashdy, PA-C
• Jaime B Elston, LSW
• Embark Therapy, LLC
• Embassy of East Mountain LLC (Embassy of East Mountain)
• Embassy of Wyoming Valley LLC (Embassy of Wyoming Valley)

• Nurse Practitioner in Wilkes Barre, PA
• Providers in Wilkes Barre, PA by specialty
• Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.